title: Health-risk appraisal with or without disease management for worksite cardiovascular risk reduction.
abstract: OBJECTIVE
  Worksite health promotion programs use health risk appraisal (HRA) surveys to identify employees at increased risk, then provide a range of interventions to encourage high-risk individuals to improve their health. Our objective was to determine how the intensity of intervention after HRA affected cardiovascular risk after 1 year, comparing individual follow-up counseling with environmental supports.
  
  
  METHODS
  133 employees of Vanderbilt University with cardiovascular risk factors were randomly assigned to worksite HRA plus targeted disease management (DM group) or HRA plus information about worksite health promotion programs (HRA group). The DM group received longitudinal individualized counseling for risk reduction, whereas the HRA group members received one feedback session about their risk factors and information about free worksite health promotion programs. The main outcome measure was the difference between groups in the change in average Framingham risk score from baseline to 1 year.
  
  
  RESULTS
  There was no significant baseline difference between groups in the Framingham risk score. Among DM participants, the mean (SD) Framingham risk score decreased by 22.6%; among HRA participants, the mean score rose by 4.3% (P = .017 for the difference between groups).
  
  
  CONCLUSIONS
  In this study of employees with cardiovascular risk factors, HRA followed by individual counseling was more effective than providing information about free worksite health promotion programs.
authors.affiliation: Division of Cardiovascular Medicine, Vanderbilt University School of Medicine, and Medical Director, Dayani Center for Health and Wellness, Vanderbilt University Medical Center, Nashville, Tennessee, USA. david.maron@vanderbilt.edu
authors.forename: David J
authors.initials: DJ
authors.lastname: Maron
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Forbes
authors.forename: Jay R
authors.initials: JR
authors.lastname: Groves
authors.forename: Mary S
authors.initials: MS
authors.lastname: Dietrich
authors.forename: Patrick
authors.initials: P
authors.lastname: Sells
authors.forename: Andres G
authors.initials: AG
authors.lastname: DiGenio
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003376:Counseling / Q000458:organization & administration; D019468:Disease Management; D005240:Feasibility Studies; D005260:Female; D006266:Health Education / Q000458:organization & administration; D006293:Health Promotion / Q000458:organization & administration; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015403:Nursing Evaluation Research; D009785:Occupational Health Nursing / Q000458:organization & administration; D009786:Occupational Health Services / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D018570:Risk Assessment / Q000458:organization & administration*; D040242:Risk Reduction Behavior; D013714:Tennessee; D014495:Universities